Laserfiche WebLink
1. SEWAGE /l1w Sr SSZ .J c�c%Y� <br /> Distance to Public Sewers Connection necessary: Yes L1___1io <br /> Does existing septic system comply with Ord. 4549: Yes — No _ Unknown Ll <br /> If no;'ezplain:­' <br /> Describe septic installation to be installed: <br /> Additional information or comments: / i <br /> 2. WATER SUPPLY <br /> I* "water supplied by private well: Yes ✓No _ Is well proper: Yea No <br /> to deficiency: <br /> Does existing or proposed use make this well public water: Ye _ o <br /> Sample of well water taken: Yes No _Date Taken Results <br /> Additional information or comments: � �r�i/1 k7_� .�® Al <br /> 3. GARBAGE & FaMSE <br /> Licensed scavenger pick-up: Yes — No _ Service Area No. <br /> Other proposed disposal method: r)p r� <br /> Potential problem: <br /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL <br /> Stateossible vector <br /> p potential & necessary control: � i( <br /> 5. AIR POLLUTION POTENTIAL <br /> State possible burning or processing pollutants & necessary control: <br /> 6. TOILET/BATH FACILITIES <br /> No. & location existing: Additional facilities needed <br /> 7. ?REVIOUS 01'EhATION HIS`1ORY <br /> 8. GENERAL SANITATION <br /> State any problems not previously noted : — <br /> 9. POPULATION DENSITY <br /> Appx. No. People per sq. mi. <br />